Antidepressants: The Pills We Can't Kick

Antidepressants have become the go-to drugs of many doctors treating women—not just for depression but also for insomnia, weight loss and migraines. Yet the prescriptions may be creating more problems than they are solving. Learn how to decide what’s right for you

by Ginny Graves

Photograph: Illustrated by Oliver Munday

The early studies of SSRIs followed people for only six to eight weeks and came up with a few reported side -effects—mostly nausea and vomiting—that tended to disappear quickly. Now that these antidepressants have been on the market for more than 20 years, a fuller picture has emerged, and it shows some serious drawbacks. For example, about 40 percentof people taking SSRIs have problems with desire, arousal or orgasm. Although it’s been less well examined, a feeling of emotional numbness may be common in a subset of patients; in a small study, researchers at Case Western Reserve University School of Medicine found this condition in 80 percent of patients taking an SSRI who complained of sexual dysfunction. Also, many people gain weight on anti-depressants. The amount depends on the specific drug you take. Full doses of tricyclics, for instance, often cause users to gain more than 7 percent of their body weight, and even reduced doses are known to expand waistlines.

Moreover, there’s preliminary evidence that antidepressants may have even more dire effects. According to recent research, it’s possible that antidepressants increase the risk of everything from headaches to irritable bowel. Last year a study from Beth Israel Deaconess Medical Center in Boston found that patient mortality in the intensive care unit was 73 percent higher in those taking antidepressants.

“Serotonin regulates numerous processes, including your moods and sodium balance in your blood, and it appears that messing with that system can take a toll on how the body functions,” says Andrews. “We don’t know for sure, but it’s likely that the higher the dose and the longer you’re on antidepressants, the riskier they are.”

In light of the potential risks and drawbacks, ask your doctor about any antidepressants she prescribes. “Physicians are often too rushed to review all the pros and cons with patients, but you deserve some time and attention,” says Steve Balt, MD, a psychiatrist and editor-in-chief of The Carlat Psychiatry Report, a monthly newsletter for psychiatrists. If you can’t get all your questions answered in your initial appointment, schedule a follow-up to talk about your options, or see someone who specializes in your problem. “Antidepressants can be a viable option, but they need to be considered alongside all the other options—psychotherapy, other medications—if you want to make a truly informed decision,” Balt advises.